Headaches from running

Headaches from running


I recently treated a client with headaches that only came on when running. By working on her neck posture together with specific breathing cues, she is now able to run without triggering neck pain or headaches!


Have you ever thought about how you breathe? And how this could be related to neck pain or headaches?

You breathe 12-16 breaths per minute at rest. So that is 17,000 to 23,000 breaths each day! Any bad habits are multiplied manifold.


Running out of breath pic



The diaphragm, a sheet of muscle that contracts to draw air into your lungs, is controlled by nerves from your neck. So poor neck posture affects the efficiency of your main breathing muscle and makes you overuse your neck muscles to try get enough air in. This becomes a cycle of the neck muscles being overly tense with breathing and making it difficult to hold your neck in a good posture….so how do we break this cycle?

Physiotherapy can be immensely helpful. In my client’s case we used joint mobilisation, massage and acupuncture to allow her to relax the tense neck muscles. Then she could work on strengthening the posture muscles of her neck.


Becoming aware of your breathing pattern is the first step, try this exercise:


Breathing x's sketch



1. Sit up tall. Place one hand gently on your shoulder, and notice if your shoulder lifts up as you breathe. If it does, you are overusing your neck muscles. See if you can release tension in your neck, shoulders and jaw.


2. Next, place your hands on the outside of your ribcage. Can you feel much sideways movement at the ribcage? This is your diaphragm working, as the dome shape of the diaphragm flattens, the ribcage expands laterally. Then, place your hand on your abdomen. Can you feel much rising and falling movement here?


If you would like to see if your breathing pattern may be contributing to your neck pain or headaches, contact Alla on 02 9399 7399.


Before you jump in!

Before you jump in!

We are looking forward to a beautiful swimming season with all this warm weather! There are many benefits to swimming such as

  • Lung training: exhaling into the water is especially beneficial for asthmatics, helping with more efficient breathing patterns
  • Weightlessness, low impact on weight bearing joints
  • Relaxing nature of being in the water, an opportunity to unwind, a moving meditation
  • Core strengthening (if done correctly!) and general muscle strengthening from the resistance of the water

Recently I have seen quite a few clients with neck, upper back and shoulder discomfort from doing laps in the pool or ocean.

Swimming freestyle requires full range of motion in your neck to turn to breathe. Any restriction in your thoracic spine (upper back) also affects the quality of your swimming stroke. Tightness in the shoulders puts more strain on the spine as you power through the water.

Next time you go for a swim, try these exercises as a warm up. Not only will you feel better, your stroke and speed should improve also!

1)      Shoulder stretch at wall: Place hand on the wall and gently stretch the body away. Now place your hand on a doorway frame and lean forward, pull the shoulder back and down.

28a Pectoral release

2)      Thoracic spine mobility

  • Start with elbows bent, and fingers clasped behind your head
  • Raise the top elbow up and slightly behind
  • Let your head gently turn as you do this stretchzxc

3)      For mid back strength:

  • Lying face downwards with your arms by your side and palms facing upwards
  • Now draw the shoulder blades together and down
  • Continue to breathe as you hold in this position for 10 – 15 seconds.
  • Relax and repeat 6 – 8 timesqwe




If you would like more ideas on how to improve your swimming, book in to see one of our physiotherapists on 9399 7399. We can tailor an exercise program to your specific needs.

-Blog by Alla Melman 

What does a tight jaw have to do with back pain?

It may seem odd that when you come in with back pain, we ask you questions such as “do you grind or clench your teeth?”

BruxNeckPainStay with me, there is a very good reason.


When you tense up the jaw, it fires up many more motor units in your brain – so basically clenching your teeth increases the tension everywhere else in your body. You may have been asked to grit your teeth and squeeze your hands together to get a stronger response if your doctor is testing your reflexes. The same mechanism is at play when you spend the night grinding your teeth, or the day clenching your teeth when concentrating.


We have had a lot of success decreasing tension in the back by teaching clients to release the tension in their jaw.


Try this:

  • Gently massage your jaw in small circular movements – notice if there is any tension there
  • See if you can relax your jaw, even giving it a gentle wriggle side to side
  • If you have managed to release some jaw tension, try repeating the process until you feel it is much more relaxed
  • Try doing this a few times throughout the day, and before you go to sleep


If you would like to find out if your tight jaw might be an issue, book in to see one of our physiotherapists on 93997399. We use a combination of hands on treatment and exercise to help you relax.

-Blog by Alla Melman 25th Oct

Injury-free Skiing – Exercises

How to Improve your Performance and Have an Injury-free Ski!


It took just one hailstorm in Sydney to get me itching to ski this season. Most of us ski just a few times each year, and don’t get ourselves conditioned to ski. Try these easy ski-preparation exercises leading up to your ski holiday!


Step 1: Check your Alignment76 sit to stand

Start by preparing how you stand. Draw a mark on the centre of each kneecap and stand in front of a mirror. The mark should be directly above your second toe. Adjust your feet and knees until they are. Do a half squat, keeping the marks above your second toes, then stand back up.

Try lunging forward with one leg, keeping the mark above your second toe, then stand back up and repeat with the other leg.112a standing stability work

Repeat each exercise 30 times, squatting lower and lunging a little further forward each time.

Practice will help you align your legs properly to ski, and get you holding an edge like a pro. If you are having difficulty with these exercises, it may mean you need the canting adjusted on your ski boots.


Step 2: How’s your Balance?77b hip extension77a standing knee hug into hip extension

Most skiers put too much weight on the back of the ski. Keeping your weight even from front to back will give you more control and a faster ride. It’s great to practice weight-bearing on a balance board, bosu or duradisc.

Try this exercise on solid ground. Stand on one leg, hugging the other leg into your chest with both hands. Make sure that the centre of your kneecap is over your second toe. Get the weight on your toes the same as the weight on your heels. Once you feel steady, extend the leg and your arms behind you, keeping the weight even on toes and heels, then return to your starting position.

Repeat 10 times on each leg.79 advanced pendulum exercise

Progress to the Arabesque position, extending the leg straight behind you, with one arm extended in front. Then return to the starting position.



Step 3: Strengthening Glutes & Quads

Gluteus Medius

No sport uses Gluteus Medius as much as skiing. Good control of the hips includes having strong glute meds, and this is essential for your turns.04081502

Stand side on to a wall, with your hands on your hips. Lift the knee closest to the wall. Pushing this knee into the wall will make the glutes contract on your standing leg. Maintain your alignment and balance throughout this exercise.

Hold for 10 seconds and repeat 8-10 times each side.

To progress this exercise further, try turning out the foot you are standing on, against the resistance of the floor.

Quadriceps113 quads step strengthening

Your quads are the workhorses of your skiing. You need strength and endurance in these muscles.

Stand with one leg on a step and the step the other down towards the floor in front of you. Stop before your foot actually hits the floor and return to your starting position.

Repeat 10-15 times and do 3 sets on each leg. Maintain your alignment and balance. Move to a higher step and add weights to progress this exercise when you’re ready.



Step 4: Endurance

The fitter you are, the longer you will enjoy your day on the slopes. That chair ride up only lets you recover so much!

Running, skipping, cycling or using an elliptical trainer as often as you can – at least every second day – is the easiest way to improve your baseline fitness and endurance.

If you have the right space and equipment, in-line skating uses many of the same muscles and techniques as skiing. Jumping exercises get the heart pumpin04081501g and help prepare for those moguls. Find a sturdy, low box that you can stand on, and give yourself lots of room. (Step aerobic steps are great for this.)

Start by standing feet together on the box, and stepping one leg sideways until it touches the ground, then return to both feet together on the box. Step to the other side. Repeat 30 times to each side, and keep your alignment and balance as you go.

Once you’ve mastered this exercise, keep your feet together and jump both feet to the floor on one side, then back onto the box, then both feet to the other side. Repeat 30 times on each side.

Increase the height of the box, and try jumping forward and back when you can.



Step 5: Improve your Flexibility

Flexibility is particularly important when you are doing tricks or racing, and it is vital that you stretch any muscle that feels tight before andCalf stretch - wedge after your day on the slopes, especially as fatigue and the cold will make your muscles tighten up.

A good stretch for your calf muscles can be achieved by using a low wedge (an old cutting board against a brick or similar will do the job.) Angle the wedge down towards a wall, and stand with your back against the wall. Hold this position for 1-3 minutes with your legs straight (gastrocnemius), and then repeat with your legs a little bent to reach you61 hip flexor stretchr deeper calf muscles (soleus).


Your hip flexors will also need a good stretch after skiing. On your knees, lunge on leg forward with your pelvis tucked under, and then stretch the arm on that side over. Hold for 20 seconds, and repeat on both sides.

A simple quad stretch will also assist your muscle recovery after skiing. You can use a wall or table to support you. Stand up tall on one leg.

107 standing quads stretch

Bend the other leg and reach the foot up behind you. Hold onto your foot and try to keep your knees together. Hold for 20 seconds, and repeat on both sides.



If you follow these 5 guidelines, your performance will improve on the slopes this season, and you are much less likely to suffer injuries. Prevention is always better than cure! If you have any trouble with these exercises, or would like to improve your performance further, speak to your Physiotherapist.


At PPFC, our resident Skiing Physio is Alex Sherborne. Call to make an appointment with him on 02 9399 7399.

Why does my neck STILL hurt??

Why does my neck STILL hurt??

Neck pain can persist for many reasons, but one of the most common is that the relationship between your eye and neck muscles has changed.
Do you feel like your head is crooked when you look straight ahead? This could be a sign that it is influencing your neck pain.

The neck has receptors that tell you where your head is and whether it is straight or crooked. These receptors can be damaged through injury or wear and tear. Studies have found this to be a particular problem after a whiplash injury or if you have arthritis. Balance is an essential part of treating ankle and knee injuries, but is often overlooked in other parts of the body!



Eyes Closed

Close your eyes

Looking to left

Turn to left

Try this simple test of balance and position of your head:

1. Sit down and focus on a small spot in front of you (eg. a spot on the wall, or a part of the pattern on a curtain.)

2. Close your eyes and turn your head as far as you can to the left.

3. Keeping your eyes closed, turn your head back to where you started.

4. Open your eyes.


Looking straight

Open your eyes.

How did you go? Are your eyes focused exactly on the same small spot? Are you a little to the left or right? Are you a little above or below?

Next, try this test on your right side.

Is the result any different?


If your head is in balance, you should be able to return to your starting position, open your eyes and be looking exactly at the same spot.
Studies have found that some people are consistently off the spot by an average of 4cm. Often, they are off focus in one specific direction, but perfect in others. Computer work often requires you to quickly turn your head away from the screen, and then return to the part of the screen you were working on. Without realising, you may be constantly correcting your head position. This is often a contributing factor in neck and shoulder pain or stiffness.

The good news is that this can improve and be corrected with practice. By using head-mounted laser equipment, we are able to show you how to correct your head balance, and provide the specific exercises for you to improve your balance and also relieve your neck pain.


To find out if this is the reason for your ongoing neck pain, or to discuss what your found when doing this test, book an appointment with Alex Sherborne, or send us an email via our contact page.


Did you know that stiffness of the muscles in your neck, shoulders and mid back can cause



Did you know that the upper joints of your neck can refer pain to the front of your face just like a headache?



If you go ahead and google the amount of headaches you could compile a list of hundreds. Physiotherapy will help to assess what type of headache you have and how best to treat it!



Tension can build over time and certain muscles can refer pain to the back of the head, forehead and sometimes even behind the eye. Our posture all day, particularly if you have a desk job can be one the biggest contributors to the cause of your headaches.


Here are 3 Exercises to try at your desk:

HA 3

HA 2

HA 1















If headaches have been a persistent issue for you, book in an appointment with one of our Physiotherapists.

Call us on Ph: (02) 9399 7399 E: enquiries@physiopfc.com

Top five exercises for looking after your back

Top five exercises for looking after your back.

An article by Francine St George, extracted from news.com.au



ABOUT 80 per cent of Australians will experience an episode of back pain at some point in their lives. In my physiotherapy practice, I see quite a range of back conditions in patients of all ages. In most cases, poor posture and tight muscles require attention, in addition to overall fitness levels.


Unfortunately there is no single, magical exercise that will ‘fix’ your back, but there are plenty of stretches you can do to relieve the little niggles and twinges that we all get, and to help protect your back and neck in the long term. Here are five of my favourites. Do them every day or as needed, and in order as described below or as individual exercises.


Read the full article, including 5 effective stretches:



Call us on Ph: (02) 9399 7399 E: enquiries@physiopfc.com

Hamstring Stretches

Are you cheating with your hamstring stretches?

Alex Sherborne, Physiotherapisttouch toes


Consider yourself fit but can’t touch your toes anymore?

Hamstring tightness results from both repetitive exercise and long periods of sitting. Longer, relaxed hamstrings can relieve knee and back pain, posture and can improve your performance when running, kicking or dancing. When it comes to lengthening and relaxing these muscles, I find people are very good at cheating (whether they mean to or not!). We have two hamstring muscles on the inside of the leg and only one on the outside, so people tend to turn their leg out to make it easier.

While you are standing, bend forward and try to touch your toes. Take a mental note of how far you get. Recheck this after doing the stretch below… If you take a few minutes to do this stretch 3 times a week, you will see a huge improvement in your hamstring flexibility over time.

Lying Hamstring Stretch

Lying Hamstring Stretch
Extract New Bodyworks

Lying Hamstring Stretch

Lie on you back with one leg bent and one straight.

Loop a belt or towel around the foot of the straight leg. Use your arms to pull the leg up until a stretch is felt behind the knee – keeping the leg straight. This should be firm, but not painful.

Once the stretch has started to relax in this position, slowly rotate the leg in- you will feel an increased stretch on the inside of the knee, then rotate the leg out to decrease the stretch- all the time keeping the leg up using your belt/towel.

Repeat for 10 – 15 seconds, relax a little, then increase the stretch by moving the straight leg a little further towards your head.

Be sure to relax your neck and shoulders, and keep breathing as you do this stretch.


Call now to book your physio session with Alex Ph: (02) 9399 7399 E: enquiries@physiopfc.com

Nerve Release

Nerve Mobility (and why it’s so important!)



Your nervous system goes from the top of your head right down to your finger tips and toes. The nervous system allows us to feel both pain and sensation (sensory nerve) and allows us to contract muscles, creating movement (motor nerve).  All nerves have a definite length and this is why injury anywhere in our body can cause problems in other parts of our body. For example, a disc bulge in our lumbar spine can create tension in one or both legs – which in turn can cause pain, pins and needles, numbness or weakness.


The below exercise will help keep our nervous system mobile through a process called “neural flossing”.  Imagine each nerve as a piece of dental floss that glides through our muscle tissues as we move. Following injury, surgery or periods of poor or repetitive postures –  the nerve can be restricted somewhere along its path and this is where pain or nerve symptoms can start.


The exercise below will help you to maintain a healthy nervous system, and is of particular help if you are experiencing any of these issues:

  1. Low back pain (with or without leg symptoms)
  2. Sacro Iliac Joint (SIJ) or pelvic pain
  3. Glute (buttock) pain or spasm
  4. Recurrent hamstring or calf muscle strains
  5. Achilles or plantarfascial (sole of the foot) pain


Lower Limb Nerve Release

Lie on your side with both knees bent up and a towel between them.


Place one hand around and feel the muscles on either side of your spine. Check they are relaxed. If they are not, take your legs backwards a little until you can feel that your back muscles are totally relaxed. There must be absolutely no back pain or referred pain into the buttocks or legs in this starting position. If there is, place a small rolled up towel under your waistline until you feel your back is totally relaxed. Now flex your foot and extend the top leg at the knee, and stop as soon as you feel tightness. You may feel the back start to tighten or you may experience this as tightness in the calf or hamstring muscles. As soon as you feel this tightness, back off this tension by bending the knee, that is backing off a fully extended position. The tension wherever you are feeling it should decrease.


Now flex and point the foot from the ankle to loosen the nerve. Do this ankle movement five times, then rest the foot back onto the other foot in the starting position. Repeat this exercise with the foot, keeping the hips in this same position three times. Once you feel it getting a little easier then bring both your knees a little closer to your chest (a little more into flexion). Again extend the knee, and flex and point the foot.


Do not do the foot flexing with the nerve on full tension as this can aggravate your pain. If you experience latent pain, namely an ache that starts approximately 30 minutes after doing this exercise, then you are either doing the exercise incorrectly or it is not appropriate for you. I would recommend you consult a physiotherapist to learn how to do this exercise correctly.

58a Lower Limb Nerve Mobility_1              3b Lower Limb NM_2


Exercises extract from New Bodyworks, Copyright PPFC 2013


Call us now Ph: (02) 9399 7399 E: enquiries@physiopfc.com

Teenage Posture

21 September 2016

Teenage Posture


Growth spurts, screen time, slouching…. good posture is particularly challenging in the teenage years.


Did you know? One the last bones to finish growing is the collarbone? A slumped or slouched posture affects the shape of the spine and final shape of the adult skeleton.






Give your child the opportunity to see their avatar on a big screen!


We are offering FREE

3D Postural Assessment

30 Sept, 4 & 7 October 2016 in school holidays.

Bookings essential.

To book in for a posture screening and Teen Posture Pilates Class, call reception 9399 7399.